We have experienced a case of occult hepatocellular carcinoma metastasized to the heart in a 41 year old female. The hepatocellular carcinoma invaded the hepatic vein, grew in a snakelike fashion up the inferior vena cava and reached the right atrium. Ultrastural examination in this case confirmed the hepatocellular origin of the tumor.
Female ; Humans ; Carcinoma, Hepatocellular

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

During the last decade, with the advent of prenatal ultrasound, multicystic dysplastic kidney is diagnosed with increasing frequency But the management of multicystic dysplastic kidney continues to be an ongoing controversy regarding both its cause and its current management. Herein we reviewed the records of four cases at our hospital between 1983-1993. All were unilateral and three cases were removed surgically and last one was observed and followed up only. The first case was a ten-month-old girl who was referred to our department because of hydronephrosis of kidney. The second was a five-year-old boy with chief complaints of flank pain. The third was a three-month-old girl, and the fourth was a two-day-old girl. Last two cases were referred to our department because of a sustained cystic dilatation of kidney detected by prenatal ultrasonography.
Dilatation ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Multicystic Dysplastic Kidney* ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.
Neck* ; Posture* ; Rabbits*

The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Adenocarcinoma ; Carcinoma, Transitional Cell ; Humans ; Male ; Orchiectomy ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion

The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Adenocarcinoma ; Carcinoma, Transitional Cell ; Humans ; Male ; Orchiectomy ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion

Statistical clinical studies of pediatric urology were made on 2,803 inpatients and 2,335 operative procedures at our department from Jan. 1957 to Dec. 1996. The statistical clinical studies of pediatric urology were summarized as follows: 1. Total number of inpatients and operations was 2,586 and 2,208 in male, 217 and 127 in female, respectively. 2. Total number of pediatric inpatients and operative procedures was markedly increased since 1980. Neonates and infants were also increased since late 1980 according to activation of antenatal clinics, especially. 3. The main diseases were cryptorchidism, hypospadias, obstruction of ureteropelvic junction (UPJO), hydrocele and urethral injury. The most common involved organ was penis and scrotum followed by urethra, kidney, ureter and bladder. 4. The main operations were orchiopexy, urethroplasty, circumcision, hydrocelectomy and pyeloplasty.
Busan* ; Circumcision, Male ; Cryptorchidism ; Female ; Humans ; Hypospadias ; Infant ; Infant, Newborn ; Inpatients* ; Kidney ; Male ; Orchiopexy ; Penis ; Scrotum ; Surgical Procedures, Operative ; Ureter ; Urethra ; Urinary Bladder ; Urology*

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

From 39 eyes of 31 cases which received the cataract operation performed under the surface anesthesia by 2 specialists, 2 senior, 1 third and 1 first year residents at Red cross Society, the following results were obtained. 1. The maximal value of intraocular pressure was 19.0mmHg, minimal value, 11.5mmHg and the average, 14.9mmHg just before the cataract operation. 2. The rupture of the capsule was 21.4% and the loss of vitreous body, 7.1% in intraocular lens extrations. 3. The degree of anteior projetion of the eyes had not direct relationship with the intracapsular lens extraction. 4. All patients who received the cataract operation were required sufficient akinesia sedation. 5. Within normal intraocular pressure, the intraocular pressure didn't seem to have any effect to the loss of vitreous body.
Anesthesia ; Cataract* ; Humans ; Intraocular Pressure* ; Lenses, Intraocular ; Red Cross ; Rupture ; Specialization ; Vitreous Body